By Catherine Murombedzi

TWO decades ago, the mentioning of Acquired Immune Deficiency Syndrome (AIDS) brought chilling moments. Then, it was a death sentence and testing positive to the virus (human immune virus) HIV was met with mixed reactions.
Some people committed suicide.
There were even tales of revenge mission as an HIV positive person would spread the virus wilfully and intentionally.
The argument was that: I also unknowingly acquired it, so, I pass it on.
This was sad.
Laws on wilful infection were then enacted and it became a crime to intentionally pass the HIV virus.
Today, the outlook has changed, thanks to the dynamics of science, technology, prevention calls and awareness campaigns.
Zimbabwe has made significant gains in lowering the rates of new HIV infections. More people are now able to live with the HIV virus for longer periods, thanks to the advent of anti-HIV medications which have given people living with HIV a new lease of life.
In Zimbabwe, the anti-HIV medications were rolled out on a large scale in 2004.
Before the advent of the life-saving drugs, most people who had the virus made a union with the cemeteries.
The HIV virus locally has the face of the female as shown by statistics.
HIV prevalence among adults aged 15 to 64 years in Zimbabwe is currently at 14,6 percent.
It stands at 16,7 percent among females and 12, 4 percent among males.
This corresponds to approximately 1,2 million people living with HIV (PLHIV) aged 15 to 64 years in the country, reports the National AIDS Council (NAC).
HIV prevalence peaks at nearly 30 percent for both females (29,8 percent) and males (28,7 percent), but occurs at a slightly older age among males (45 to 49 years) as compared to females (40 to 44 years).
The disparity in HIV prevalence by sex is most pronounced among young adults.
The HIV virus is higher in females aged 20 to 24 years while the males are not as badly affected as the females.
HIV prevalence among 20 to 24-year-olds is three times higher among females (8,5 percent) than males (2,7 percent).
Among adults aged 15 to 64 years, prevalence of HIV varies geographically, ranging from 11,4 percent in Manicaland to 20,1 percent in Matabeleland North and 22,3 percent in Matabeleland South (NAC 2015).
When an HIV positive person takes medication religiously and the medication is working well, then the HIV virus is suppressed.
Prevalence of viral load suppression (VLS) among HIV-positive adults aged 15 to 64 years is 60,4 percent.
It stands at 64,5 percent among females and 54,3 percent among males. It would be interesting if a study would be taken to explain the variance of suppression by province.
Matebeleland South, Matebeleland North and Bulawayo provinces range above 63 percent doing well in the suppression graph.
Manicaland, Masvingo and Midlands provinces follow, also ranging above 60 percent.
Among HIV-positive adults aged 15 to 64 years, prevalence of VLS varies geographically across Zimbabwe, ranging from 54,3 percent in Mashonaland East to 66,1 percent in Matabeleland North.
Dr Owen Mugurungi, the director of TB and AIDS in the Ministry of Health and Child Care, said the country stands to gain more with viral load suppression.
He said when the virus is suppressed, chances of passing it on become minimal.
“Early HIV treatment reduces the risk of HIV transmission. Viral load suppression will see the rate of new HIV infection lowered,” said Dr Mugurungi.
Dr Mugurungi said that treatment then becomes a prevention tool.
“Treatment then becomes prevention. A person with a fully suppressed viral load does not pass the virus to his/her partner if they are in a discordant relationship. As a country, we strive to achieve the 90-90-90 where 90 percent of people on ART will record viral suppression,” said Dr Mugurungi.
A breast feeding mother with a suppressed viral load does not pass the HIV virus to her baby.
Currently in Zimbabwe, less than 6 percent of babies are now born with the HIV virus, thanks to the prevention of mother-to-child transmission programme (PMTCT). The country strives to have no baby born with the HIV virus by 2020.
Dr Angela Mushavi said it is possible to have no child born with the HIV virus.
“When the PMTCT programme began, we aimed at having 12 percent of babies born carrying the HIV virus, but today we are proud to say this has gone down, working with partners the Elizabeth Glaser Paediatric AIDS Foundation, the rate from mother-to-child transmission is now 6 percent. We can go below 5 percent,” said Dr Mushavi.
“We have seen that eliminating HIV in paediatrics is possible. Cuba eliminated mother-to-child HIV infection in 2015 and the World Health Organisation certified that. As a country, Zimbabwe is working towards elimination of HIV infection in children, it is possible. Until no child is born with the HIV virus, then can we say we have done it,” added Dr Mushavi.
Results published in 2015 called HPTN 052 Study showed treatment as prevention of HIV transmission from people with fully suppressed viral load.
The first results from the study also demonstrated that early HIV treatment reduced the risk of HIV transmission by 96 percent.
These results were presented in 2015 by Professor Myron Cohen at the ‘Eighth International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention’ in Vancouver, Canada.
The objective of the anti-retroviral therapy (ART) programme is to reduce morbidity and mortality due to AIDS-related deaths through provision of anti-HIV medication.
To align treatment strategies to achieve the 90-90-90 targets, the country has adopted viral load monitoring and is in the process of rolling out and equipping health facilities.
With 2030 in mind, the 90-90-90 is an ambitious programme to have 90 percent of any country population tested for HIV.
The second 90 means 90 percent of the tested people who need ART receive the required medication.
The last 90 means that the people on medication must record 90 percent viral suppression leading to end of the AIDS epidemic.
In 2015, a total of 879 000 were on ART, increasing to 940 000 in 2016.
The domestic funding, which is the AIDS Levy, supports 232 000 people. The rest of people receiving ART are supported by the Global Fund, the US President’s Emergency Plan for AIDS Relief (PEPFAR) and partners.
As a country, Zimbabwe needs to uphold prevention as the cornerstone of success. Those on anti-HIV treatment must also strive to get viral load suppression after starting medication.
This is achieved if medication is working well, the person taking the medication has 100 percent adherence and reports early to the health centre if he/she experiences any side effects or an anomaly in his/her day-to-day living.